proposed form n-4
TRANSCRIPT
PROPOSED FORM N-4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM N-4 REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
Pre-Effective Amendment No. Post-Effective Amendment No.
and/or
REGISTRATION STATEMENT UNDER THE INVESTMENT COMPANY ACT OF 1940 Amendment No.
(Check appropriate box or boxes.)
(Exact Name of Registrant)
(Name of Depositor)
(Address of Depositor’s Principal Executive Offices) (Zip Code) Depositor’s Telephone Number, including Area Code
(Name and Address of Agent for Service) Approximate Date of Proposed Public Offering
It is proposed that this filing will become effective (check appropriate box): immediately upon filing pursuant to paragraph (b) on (date) pursuant to paragraph (b) 60 days after filing pursuant to paragraph (a)(1) on (date) pursuant to paragraph (a)(1) of rule 485.
If appropriate, check the following box:
this post-effective amendment designates a new effective date for a previously filed post-effective amendment.
Omit from the facing sheet reference to the other Act if the Registration Statement or amendment is filed under only one of the Acts. Include the “Approximate Date of Proposed Public Offering” only where securities are being registered under the Securities Act of 1933.
Form N-4 is to be used by separate accounts that are unit investment trusts that offer variable annuity contracts to register under the Investment Company Act of 1940 and to offer their securities under the Securities Act of 1933. The Commission has designed Form N-4 to provide investors with information that will assist them in making a decision about investing in a variable annuity contract. The Commission also may use the information provided in Form N-4 in its regulatory, disclosure review, inspection, and policy making roles.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
You may not send a completed printout of this form to the SEC to satisfy a filing obligation. You can only satisfy an SEC filing obligation by submitting the information required by this form to the SEC in electronic format online at https://www.edgarfiling.sec.gov.
OMB APPROVAL OMB Number: 3235-0318 Expires: [ ] Estimated average burden hours per response: [ ]
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A Registrant is required to disclose the information specified by Form N-4, and the Commission will make this information public. A Registrant is not required to respond to the collection of information contained in Form N-4 unless the Form displays a currently valid Office of Management and Budget (“OMB”) control number. Please direct comments concerning the accuracy of the information collection burden estimate and any suggestions for reducing the burden to Secretary, Securities and Exchange Commission, 100 F Street, N.E., Washington, DC 20549. The OMB has reviewed this collection of information under the clearance requirements of 44 U.S.C. § 3507.
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CONTENTS OF FORM N-4
GENERAL INSTRUCTIONS ............................................................................................................................................................... iv A. Definitions ........................................................................................................................................................................................ iv B. Filing and Use of Form N-4 ............................................................................................................................................................. iv C. Preparation of the Registration Statement ......................................................................................................................................... v D. Incorporation by Reference ............................................................................................................................................................. vii
PART A - INFORMATION REQUIRED IN A PROSPECTUS ......................................................................................................... 1 Item 1. Front and Back Cover Pages ......................................................................................................................................................... 1 Item 2. Overview of the Contract .............................................................................................................................................................. 2 Item 3. Key Information ........................................................................................................................................................................... 2 Item 4. Fee Table ...................................................................................................................................................................................... 6 Item 5. Principal Risks of Investing in the Contract ................................................................................................................................. 9 Item 6. General Description of Registrant, Depositor, and Portfolio Companies ..................................................................................... 9 Item 7. Charges ......................................................................................................................................................................................... 9 Item 8. General Description of Contracts ............................................................................................................................................... 10 Item 9. Annuity Period ............................................................................................................................................................................ 12 Item 10. Standard Death Benefit ............................................................................................................................................................. 12 Item 11. Other Benefits Available Under the Contract ........................................................................................................................... 13 Item 12. Purchases and Contract Value .................................................................................................................................................. 14 Item 13. Surrenders and Withdrawals ..................................................................................................................................................... 14 Item 14. Loans ........................................................................................................................................................................................ 15 Item 15. Taxes ......................................................................................................................................................................................... 15 Item 16. Legal Proceedings ..................................................................................................................................................................... 15 Item 17. Financial Statements ................................................................................................................................................................. 15 Item 18. Portfolio Companies Available Under the Contract ................................................................................................................. 16
PART B - INFORMATION REQUIRED IN A STATEMENT OF ADDITIONAL INFORMATION ........................................ 18 Item 19. Cover Page and Table of Contents ........................................................................................................................................... 18 Item 20. General Information and History .............................................................................................................................................. 18 Item 21. Services ..................................................................................................................................................................................... 18 Item 22. Purchase of Securities Being Offered ....................................................................................................................................... 19 Item 23. Underwriters ............................................................................................................................................................................. 20 Item 24. Calculation of Performance Data .............................................................................................................................................. 20 Item 25. Annuity Payments ..................................................................................................................................................................... 22 Item 26. Financial Statements ................................................................................................................................................................. 22 Item 27. Condensed Financial Information ............................................................................................................................................. 24
PART C - OTHER INFORMATION .................................................................................................................................................. 25 Item 28. Exhibits ..................................................................................................................................................................................... 25 Item 29. Directors and Officers of the Depositor .................................................................................................................................... 26 Item 30. Persons Controlled by or Under Common Control with the Depositor or Registrant............................................................... 26 Item 31. Indemnification ......................................................................................................................................................................... 26 Item 32. Principal Underwriters .............................................................................................................................................................. 26 Item 33. Location of Accounts and Records ........................................................................................................................................... 27 Item 34. Management Services ............................................................................................................................................................... 27 Item 35. Fee Representation.................................................................................................................................................................... 27
SIGNATURES ....................................................................................................................................................................................... 28
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GENERAL INSTRUCTIONS A. Definitions
References to sections and rules in this Form N-4 are to the Investment Company Act of 1940 [15 U.S.C. 80a-1 et seq.] (the “Investment Company Act”), unless otherwise indicated. Terms used in this Form N-4 have the same meaning as in the Investment Company Act or the related rules, unless otherwise indicated. As used in this Form N-4, the terms set out below have the following meanings:
“Class” means a class of a Variable Annuity Contract that varies principally with respect to distribution-related fees and expenses. “Contractowner Account” means any account of a contractowner, participant, annuitant, or beneficiary to which (net) purchase
payments under a variable annuity contract are added and from which administrative or transaction charges may be subtracted. “Depositor” means the person primarily responsible for the organization of the Registrant and the person, other than the trustee or
custodian, who has continuing functions or responsibilities with respect to the administration of the affairs of the Registrant. “Depositor” includes the sponsoring insurance company that establishes and maintains the Registrant. If there is more than one Depositor, the information called for in this Form about the Depositor shall be provided for each Depositor.
“Portfolio Company” means any company in which the Registrant invests and which may be selected as an option by the
contractowner. “Registrant” means the separate account (as defined in Section 2(a)(37) of the Investment Company Act [15 U.S.C. 80a-
2(a)(37)]) that offers the Variable Annuity Contracts. “SAI” means the Statement of Additional Information required by Part B of this Form. “Securities Act” means the Securities Act of 1933 [15 U.S.C. 77a et seq.]. “Securities Exchange Act” means the Securities Exchange Act of 1934 [15 U.S.C. 78a et seq.]. “Statutory Prospectus” means a prospectus that satisfies the requirements of section 10(a) of the Securities Act [15 U.S.C. 77j(a)]. “Summary Prospectus” has the meaning provided by paragraph (a)(12) of rule 498A under the Securities Act [17 CFR
230.498A(a)(12)]. “Variable Annuity Contract” or “Contract” means any accumulation contract or annuity contract, any portion thereof, or any unit
of interest or participation therein pursuant to which the value of the contract, either during an accumulation period or after annuitization, or both, varies according to the investment experience of the separate account in which the contract participates. Unless the context otherwise requires, “Variable Annuity Contract” or “Contract” refers to the Variable Annuity Contracts being offered pursuant to the registration statement prepared on this Form. B. Filing and Use of Form N-4
1. What is Form N-4 used for?
Form N-4 is used by all separate accounts organized as unit investment trusts and offering Variable Annuity Contracts to file:
(a) An initial registration statement under the Investment Company Act and any amendments to the registration statement;
(b) An initial registration statement required under the Securities Act and any amendments to the registration statement, including amendments required by section 10(a)(3) of the Securities Act [15 U.S.C. 77j(a)(3)]; or
(c) Any combination of the filings in paragraph (a) or (b).
2. What is included in the registration statement?
(a) For registration statements or amendments filed under both the Investment Company Act and the Securities Act or only
under the Securities Act, include the facing sheet of the Form, Parts A, B, and C, and the required signatures.
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(b) For registration statements or amendments filed only under the Investment Company Act, include the facing sheet of the Form, responses to all Items of Parts A (except Items 1, 4, 5, 9, 10, and 17), B, and C (except Items 28(c), (k), (l), and (m)), and the required signatures.
3. What are the fees for Form N-4?
No registration fees are required with the filing of Form N-4 to register as an investment company under the Investment Company Act or to register securities under the Securities Act. If Form N-4 is filed to register securities under the Securities Act and securities are sold to the public, registration fees must be paid on an ongoing basis after the end of the Registrant’s fiscal year. See section 24(f) [15 U.S.C. 80a-24(f)] and related rule 24f-2 [17 CFR 270.24f-2].
4. What rules apply to the filing of a registration statement on Form N-4?
(a) For registration statements and amendments filed under both the Investment Company Act and the Securities Act or
under only the Securities Act, the general rules regarding the filing of registration statements in Regulation C [17 CFR 230.400 – 230.498A] apply to the filing of registration statements on Form N-4. Specific requirements concerning investment companies appear in rules 480 - 485 and 495 - 498A of Regulation C.
(b) For registration statements and amendments filed only under the Investment Company Act, the general provisions in
rules 8b-1 – 8b-32 [17 CFR 270.8b-l to 8b-32] apply to the filing of registration statements on Form N-4.
(c) The plain English requirements of rule 421 under the Securities Act [17 CFR 230.421] apply to prospectus disclosure in Part A of Form N-4.
(d) Regulation S-T [17 CFR 232.10 – 232.903] applies to all filings on the Commission’s Electronic Data Gathering,
Analysis, and Retrieval system (“EDGAR”).
C. Preparation of the Registration Statement
1. Administration of the Form N-4 requirements
(a) The requirements of Form N-4 are intended to promote effective communication between the Registrant and prospective investors. A Registrant’s prospectus should clearly disclose the fundamental features and risks of the Variable Annuity Contracts, using concise, straightforward, and easy to understand language. A Registrant should use document design techniques that promote effective communication.
(b) The prospectus disclosure requirements in Form N-4 are intended to elicit information for an average or typical investor
who may not be sophisticated in legal or financial matters. The prospectus should help investors to evaluate the risks of an investment and to decide whether to invest in a Variable Annuity Contract by providing a balanced disclosure of positive and negative factors. Disclosure in the prospectus should be designed to assist an investor in comparing and contrasting a Variable Annuity Contract with other Contracts.
(c) Responses to the Items in Form N-4 should be as simple and direct as reasonably possible and should include only as
much information as is necessary to enable an average or typical investor to understand the particular characteristics of the Variable Annuity Contracts. The prospectus should avoid including lengthy legal and technical discussions and simply restating legal or regulatory requirements to which Contracts generally are subject. Brevity is especially important in describing the practices or aspects of the Registrant’s operations that do not differ materially from those of other separate accounts. Avoid excessive detail, technical or legal terminology, and complex language. Also avoid lengthy sentences and paragraphs that may make the prospectus difficult for many investors to understand and detract from its usefulness.
(d) The requirements for prospectuses included in Form N-4 will be administered by the Commission in a way that will
allow variances in disclosure or presentation if appropriate for the circumstances involved while remaining consistent with the objectives of Form N-4.
2. Form N-4 is divided into three parts:
(a) Part A. Part A includes the information required in a Registrant’s prospectus under section 10(a) of the Securities Act.
The purpose of the prospectus is to provide essential information about the Registrant and the Contracts in a way that will help investors to make informed decisions about whether to purchase the securities described in the prospectus. In responding to the Items in Part A, avoid cross-references to the SAI. Cross-references within the prospectus are most
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useful when their use assists investors in understanding the information presented and does not add complexity to the prospectus.
(b) Part B. Part B includes the information required in a Registrant’s SAI. The purpose of the SAI is to provide additional
information about the Registrant and the Contracts that the Commission has concluded is not necessary or appropriate in the public interest or for the protection of investors to be in the prospectus, but that some investors may find useful. Part B affords the Registrant an opportunity to expand discussions of the matters described in the prospectus by including additional information that the Registrant believes may be of interest to some investors. The Registrant should not duplicate in the SAI information that is provided in the prospectus, unless necessary to make the SAI comprehensible as a document independent of the prospectus.
(c) Part C. Part C includes other information required in a Registrant’s registration statement.
3. Additional Matters:
(a) Organization of Information. Organize the information in the prospectus and SAI to make it easy for investors to understand. Notwithstanding rule 421(a) under the Securities Act [17 CFR 230.421(a)] regarding the order of information required in a prospectus, disclose the information required by Item 2 (Overview of the Contract) and Item 3 (Key Information), and Item 4 (Fee Table) in numerical order at the front of the prospectus. Do not precede Items 2, 3, and 4 with any other Item except the Cover Page (Item 1), a glossary, if any (General Instruction C.3.(d)), or a table of contents meeting the requirements of rule 481(c) under the Securities Act [17 CFR 230.481(c)]. If the discussion of the information required by Items 2 or 3 also responds to disclosure requirements in other items of the prospectus, a Registrant need not include additional disclosure in the prospectus that repeats the information disclosed in response to those items.
(b) Other Information. A Registrant may include, except in response to Items 2 and 3, information in the prospectus or the
SAI that is not otherwise required so long as the information is not incomplete, inaccurate, or misleading and does not, because of its nature, quantity, or manner of presentation, obscure or impede understanding of the information that is required to be included. For example, Registrants are free to include in the prospectus financial statements required to be in the SAI, and may include in the SAI financial statements that may be placed in Part C.
(c) Presentation of Information. To aid investor comprehension, Registrants are encouraged to use, as appropriate,
question-and-answer formats, tables, side-by-side comparisons, captions, bullet points, numeric examples, illustrations or similar presentation methods. For example, such presentation methods would be appropriate when presenting disclosure for similar Contract features, prospectuses describing multiple Variable Annuity Contracts, or the operation of optional benefits or annuitization.
(d) Definitions. Define the special terms used in the prospectus (e.g., accumulation unit, contractowner, participant,
sub-account, etc.) in any presentation that clearly conveys meaning to investors. If the Registrant elects to include a glossary or list of definitions, only special terms used throughout the prospectus must be defined or listed. If a special term is used in only one section of the prospectus, it may be defined there (and need not be included in any glossary or list of definitions that the Registrant includes).
(e) Use of Form N-4 to Register Multiple Contracts.
(i) A single prospectus may describe multiple Contracts that are essentially identical. Whether the prospectus describes
Contracts that are “essentially identical” will depend on the facts and circumstances. For example, a Contract that does not offer optional benefits would not be essentially identical to one that does. Similarly, group and individual Contracts would not be essentially identical. However, Contracts that vary only due to state regulatory requirements would be essentially identical.
(ii) Similarly, multiple prospectuses may be combined in a single registration statement on Form N-4 when the
prospectuses describe Contracts that are essentially identical. For example, a Registrant could determine it is appropriate to include multiple prospectuses in a registration statement in the following situations: (i) the prospectuses describe the same Contract that is sold through different distribution channels; (ii) the prospectuses describe Contracts that differ only with respect to underlying funds offered; or (iii) the prospectuses describe both the original and an “enhanced” version of the same Contract (where the “enhanced” version modifies the features or options that the Registrant offers under that Contract).
(iii) Paragraph (a) of General Instruction C.3 requires Registrants to disclose the information required by Items 2, 3, and
4 in numerical order at the front of the prospectus and generally not to precede the Items with other information. As a general matter, Registrants providing disclosure in a single prospectus for more than one Variable Annuity
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Contract, or for Contracts sold in both the group and individual markets, may depart from the requirement of paragraph (a) as necessary to present the required information clearly and effectively (although the order of information required by each Item must remain the same). For example, the prospectus may present all of the Item 2 information for several Variable Annuity Contracts, followed by all of the Item 3 information for the Contracts, and followed by all of the Item 4 information for the Contracts. Alternatively, the prospectus may present Items 2, 3, and 4 for each of several Contracts sequentially. Other presentations also would be acceptable if they are consistent with the Form’s intent to disclose the information required by Items 2, 3, and 4 in a standard order at the beginning of the prospectus.
(f) Dates. Rule 423 under the Securities Act [17 CFR 230.423] applies to the dates of the prospectuses and the SAI. The
SAI should be made available at the same time that the prospectus becomes available for purposes of rules 430 and 460 under the Securities Act [17 CFR 230.430 and 230.460].
(g) Sales Literature. A Registrant may include sales literature in the prospectus so long as the amount of this information
does not add substantial length to the prospectus and its placement does not obscure essential disclosure.
(h) Interactive Data File
(i) An Interactive Data File (§232.11 of this chapter) is required to be submitted to the Commission in the manner provided by Rule 405 of Regulation S-T (§232.405 of this chapter) for any registration statement or post-effective amendment thereto on Form N-4 that includes or amends information provided in response to Items 3, 4, 5, 11, or 18.
(A) Except as required by paragraph (h)(i)(B), the Interactive Data File must be submitted as an amendment to the
registration statement to which the Interactive Data File relates. The amendment must be submitted on or before the date the registration statement or post-effective amendment that contains the related information becomes effective.
(B) In the case of a post-effective amendment to a registration statement filed pursuant to paragraphs (b)(1)(i), (ii),
(v), (vi), or (vii) of rule 485 under the Securities Act [17 CFR 230.485(b)], the Interactive Data File must be submitted either with the filing, or as an amendment to the registration statement to which the Interactive Data Filing relates that is submitted on or before the date the post-effective amendment that contains the related information becomes effective.
(ii) An Interactive Data File is required to be submitted to the Commission in the manner provided by rule 405 of
Regulation S-T for any form of prospectus filed pursuant to paragraphs (c) or (e) of rule 497 under the Securities Act [17 CFR 230.497(c) or (e)] that includes information provided in response to Items 3, 4, 5, 11, or 18 that varies from the registration statement. The Interactive Data File must be submitted with the filing made pursuant to rule 497.
(iii) The Interactive Data File must be submitted in accordance with the specifications in the EDGAR Filer Manual, and
in such a manner that will permit the information for each Contract, and, for any information that does not relate to all of the Classes in a filing, each Class of the Contract to be separately identified.
(i) Website Addresses and Cross-References. Any website address or cross-reference that is included in an electronic
version of the Statutory Prospectus must be an active hyperlink. This requirement does not apply to Statutory Prospectuses that are filed on the EDGAR system. Rule 105 of Regulation S-T [17 CFR 232.405] prohibits hyperlinking to websites, locations, or other documents that are outside of the EDGAR system.
D. Incorporation by Reference
1. Specific rules for incorporation by reference in Form N-4:
(a) A Registrant may not incorporate by reference into a prospectus information that Part A of this Form requires to be included in a prospectus, except as specifically permitted by Part A of the Form.
(b) A Registrant may incorporate by reference any or all of the SAI into the prospectus (but not to provide any information
required by Part A to be included in the prospectus) without delivering the SAI with the prospectus. (c) A Registrant may incorporate by reference into the SAI or its response to Part C information that Parts B and C require
to be included in the Registrant’s registration statement.
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2. General Requirements.
All incorporation by reference must comply with the requirements of this Form and the following rules on incorporation by reference: rule 10(d) of Regulation S-K under the Securities Act [17 CFR 229.10(d)] (general rules on incorporation by reference, which, among other things, prohibit, unless specifically required by this Form, incorporating by reference a document that includes incorporation by reference to another document, and limits incorporation to documents filed within the last 5 years, with certain exceptions); rule 411 under the Securities Act [17 CFR 230.411] (general rules on incorporation by reference in a prospectus); rule 303 of Regulation S-T [17 CFR 232.303] (specific requirements for electronically filed documents); and rules 0-4, 8b-23, and 8b-32 [17 CFR 270.0-4, 270.8b-23, and 270.8b-32] (additional rules on incorporation by reference for investment companies).
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PART A - INFORMATION REQUIRED IN A PROSPECTUS
Item 1. Front and Back Cover Pages
(a) Front Cover Page. Include the following information on the outside front cover page of the prospectus:
(1) The Registrant’s name.
(2) The Depositor’s name.
(3) The types of Variable Annuity Contracts offered by the prospectus (e.g., group, individual, single premium immediate, flexible premium deferred).
(4) The name of the Contract and the Class or Classes, if any, to which the Contract relates.
(5) The date of the prospectus.
(6) The statement required by rule 481(b)(1) under the Securities Act.
(7) The statement that additional information about certain investment products, including variable annuities, has been prepared by the Securities and Exchange Commission’s staff and is available at Investor.gov.
(8) The legend: “If you are a new investor in the [Contract], you may cancel your [Contract] within 10 days of receiving it
without paying fees or penalties. In some states, this cancellation period may be longer. Upon cancellation, you will receive either a full refund of the amount you paid with your application or your total contract value. You should review this prospectus, or consult with your investment professional, for additional information about the specific cancellation terms that apply.”
Instruction. A Registrant may include on the front cover page any additional information, subject to the requirements of General Instruction C.3.(b) and (c).
(b) Back Cover Page. Include the following information on the outside back cover page of the prospectus:
(1) A statement that the SAI includes additional information about the Registrant. Explain that the SAI is available, without
charge, upon request, and explain how contractowners may make inquiries about their Contracts. Provide a toll-free (or collect) telephone number for investors to call: to request the SAI; to request other information about the Contracts; and to make contractowner inquiries.
Instructions.
1. A Registrant may indicate, if applicable, that the SAI and other information are available on its internet site and/or by
email request.
2. A Registrant may indicate, if applicable, that the SAI and other information are available from an insurance agent or financial intermediary (such as a broker-dealer or bank) through which the Contracts may be purchased or sold.
3. When a Registrant (or an insurance agent or financial intermediary through which Contracts may be purchased or sold) receives a request for the SAI, the Registrant (or insurance agent or financial intermediary) must send the SAI within 3 business days of receipt of the request, by first-class mail or other means designed to ensure equally prompt delivery.
(2) A statement whether and from where information is incorporated by reference into the prospectus as permitted by General
Instruction D. Unless the information is delivered with the prospectus, explain that the Registrant will provide the information without charge, upon request (referring to the telephone number provided in response to paragraph (b)(i)).
Instruction. The Registrant may combine the information about incorporation by reference with the statements required under paragraph (b)(i).
(3) A statement that reports and other information about the Registrant are available on the Commission’s Internet site at
http://www.sec.gov, and that copies of this information may be obtained, upon payment of a duplicating fee, by electronic request at the following email address: [email protected].
(4) The EDGAR contract identifier for the Contract on the bottom of the back cover page in type size smaller than that
generally used in the prospectus (e.g., 8-point modern type).
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Item 2. Overview of the Contract
Provide a concise description of the Contract including the following information:
(a) Purpose. Briefly describe the purpose(s) of the Contract (e.g., to help the contractowner accumulate assets through an
investment portfolio, to provide or supplement the contractowner’s retirement income, to provide death and/or other benefits). State for whom the Contract may be appropriate (e.g., by discussing a representative investor’s time horizon, liquidity needs, and financial goals).
(b) Phases of Contract. Briefly describe the accumulation (savings) phase and annuity (income) phase of the Contract.
(1) This discussion should include of brief overview of the investment options available under the Contract (e.g., any Portfolio Companies, as well as any general (fixed) account options).
Instructions.
1. Prominently disclose that additional information about each Portfolio Company is provided in an appendix to the prospectus, and provide a cross-reference to the relevant appendix.
2. A detailed explanation of the separate account, sub-accounts, and Portfolio Companies is not necessary and should be avoided.
(2) State, if applicable, that if a contractowner annuitizes, he or she will receive a stream of income payments, however (i) he
or she will be unable to make withdrawals and (ii) death benefits and living benefits will terminate.
(c) Contract Features. Summarize the Contract’s primary features, including death benefits, withdrawal options, loan provisions, and any available optional benefits. If applicable, state that the contractowner will incur an additional fee for selecting a particular benefit.
Item 3. Key Information
Include the following information:
Important Information You Should Consider About the Contract An investment in the Contract is subject to fees, risks, and other important considerations, some of which are briefly summarized in the following table. You should review the prospectus for additional information about these topics.
FEES AND EXPENSES
Surrender Charge (charges for early withdrawal)
Transaction Charges (charges for certain transactions)
Ongoing Fees and Expenses (annual charges)
RISKS
Risk of Loss
Not a Short-Term Investment
Risks Associated with Investment Options
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Insurance Company Risks
RESTRICTIONS
Investment Options
Optional Benefits
TAXES
Tax Implications
CONFLICTS OF INTEREST
Investment Professional Compensation
Exchanges
Instructions.
1. General.
(a) A Registrant should disclose the required information in the tabular presentation(s) reflected herein, in the order
specified. A Registrant may exclude any disclosures that are not applicable, or modify any of the statements required to be included, so long as the modified statement contains comparable information.
(b) A Registrant should provide cross-references to the location in the Statutory Prospectus where the subject matter is described in greater detail. Cross-references in electronic versions of the Summary Prospectus and/or Statutory Prospectus should link directly to the location in the Statutory Prospectus where the subject matter is discussed in greater detail. The cross-reference should be adjacent to the relevant disclosure, either within the table row, or presented in an additional table column.
(c) All disclosures provided in response to this Item 3 should be short and succinct, consistent with the limitations of a tabular presentation.
2. Fees and Expenses. (a) Surrender Charges (charges for early withdrawal). Include a statement that if the contractowner withdraws money
from the Contract within [x] years following his or her last premium payment, he or she will be assessed a surrender charge. Include in this statement the maximum surrender charge (as a percentage of [contribution/premium or amount surrendered]), and the maximum number of years that a surrender charge may be assessed since the last premium payment under the contract. Provide an example of the maximum surrender charge a contractowner could pay (in dollars) under the Contract assuming a $100,000 investment (e.g., “[i]f you make an early withdrawal, you could pay a surrender charge of up to $9,000 on a $100,000 investment.”).
(b) Transaction Charges (charges for certain transactions). State that in addition to surrender charges (if applicable) the contractowner may also be charged for other transactions, and provide a brief narrative description of the types of such charges (e.g., front-end loads, charges for transferring cash value between investment options, charges for wire transfers, etc.).
(c) Ongoing Fees and Expenses (annual charges).
Include the following information, in the order specified: (i) Minimum and Maximum Annual Fee Table.
(A) The legend: “The table below describes the fees and expenses that you may pay each year, depending on the
options you choose. Please refer to your contract specifications page for information about the specific fees you will pay each year based on the options you have elected.”
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(B) Provide Minimum and Maximum Annual Fees in substantially the following tabular format, in the order
specified.
i. ii.
(C) Explain, in a parenthetical or footnote to the table or each caption, the basis for each percentage (e.g., % of separate account value or benefit base, or % of net asset value).
(D) If a Registrant offers multiple Portfolio Companies, it should disclose the minimum and maximum “Total
Annual [Portfolio Company] Operating Expenses” calculated in accordance with Item 3 of Form N-1A (before expense reimbursements or fee waiver arrangements).
(E) The Minimum Annual Fee means the lowest available current fee for each annual fee category (i.e., the least
expensive contract class, the lowest Total Annual Portfolio Company Operating Expense, and the least expensive optional benefit available for an additional charge). The Maximum Annual Fee means the highest available current fee for each annual fee category (i.e., the most expensive contract class, the highest Portfolio Company Total Operating Expense, and the most expensive optional benefit available for an additional charge).
(ii) Lowest and Highest Annual Cost Table.
(A) The legend: “Because your contract is customizable, the choices you make affect how much you will pay. To help you understand the cost of owning your contract, the following table shows the lowest and highest cost you could pay each year. This estimate assumes that you do not take withdrawals from the contract, which could add surrender charges that substantially increase costs.”
(B) Provide Lowest and Highest Annual Costs in substantially the following tabular format, in the order specified.
Lowest Annual Cost:
$[ ] Highest Annual Cost:
$[ ] Assumes:
• Investment of $100,000 • 5% annual appreciation • Least expensive combination of
contract classes and Portfolio Company fees and expenses
• No optional benefits • No sales charges • No additional contributions, transfers
or withdrawals
Assumes:
• Investment of $100,000 • 5% annual appreciation • Most expensive combination of
classes, optional benefits, and Portfolio Company fees and expenses
• No sales charges • No additional contributions, transfers
or withdrawals
(C) Calculate the Lowest and Highest Annual Cost estimates in the following manner:
a. Calculate the dollar amount of fees that would be assessed based on the assumptions described in the
table above for each of the first 10 Contract years.
b. Total each year’s fees (discounted to the present value using a 5% annual discount rate) and divide by 10 to calculate the estimated dollar amounts that are required to be set forth in the table above.
c. Sales loads, other than ongoing sales charges, may be excluded from the Lowest and Highest Annual Cost estimates.
Annual Fee Minimum Maximum Base contract (varies by contract class)
[ ]% [ ]%
Investment options (Portfolio Company fees and expenses)
[ ]% [ ]%
Optional benefits (if elected)
[ ]% [ ]%
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d. Amounts of any premium bonus may be excluded from the Lowest and Highest Annual Cost estimates.
e. Unless otherwise stated, the least and most expensive combination of contract classes, Portfolio
Company fees and expenses, and optional benefits available for an additional charge should be based on the disclosures provided in the Example in Item 4. If a different combination of contract classes, Total Annual Portfolio Company Operating Expenses, and/or optional benefits available for an additional charge would result in different Minimum or Maximum fees in different years, use the least expensive or most expensive combination of contract classes, Total Annual Portfolio Company Operating Expenses, and optional benefits each year.
3. Risks.
(a) Risk of loss. State that a contractowner can lose money by investing in the Contract.
(b) Not a Short-Term Investment. State that a Contract is not a short-term investment vehicle and is not appropriate for an
investor who needs ready access to cash, accompanied by a brief explanation.
(c) Risks Associated with Investment Options. State that an investment in the Contract is subject to the risk of poor investment performance and can vary depending on the performance of the investment options available under the Contract (e.g., Portfolio Companies, as well as any fixed account investment option), that each investment option will have its own unique risks, and that the contractowner should review a Portfolio Company’s prospectus before making an investment decision.
(d) Insurance Company Risks. State that an investment in the Contract is subject to the risks related to the Depositor, including that any obligations, guarantees, or benefits are subject to the claims-paying ability of the Depositor. If applicable, further state that more information about the Depositor, including its financial strength ratings, is available upon request from the Registrant.
Instruction. A Registrant may include the Depositor’s financial strength rating(s) and omit the disclosures contemplated by the last sentence of Instruction 3.(d).
4. Restrictions.
(a) Investment Options. State whether there are any restrictions that may limit the investment options that a contractowner may choose, as well as any limitations on the transfer of contract value among Portfolio Companies. If applicable, state that the insurer reserves the right to remove or substitute Portfolio Companies as investment options.
(b) Optional Benefits. State whether there are any restrictions or limitations relating to optional benefits, and/or whether an optional benefit may be modified or terminated by the Registrant. If applicable, state that withdrawals may affect the availability of optional benefits by reducing the benefit by an amount greater than the value withdrawn, and/or could terminate a benefit.
5. Taxes—Tax Implications. State that a contractowner should consult with a tax professional to determine the tax
implications of an investment in and payments received under the Contract, and that there is no additional tax benefit to the contractowner if the Contract is purchased through a tax-qualified plan or individual retirement account (IRA). Explain that withdrawals will be subject to ordinary income tax, and may be subject to tax penalties.
6. Conflicts of Interest. (a) Investment Professional Compensation. State that some investment professionals receive compensation for selling the
Contract to investors, and briefly describe the basis upon which such compensation is typically paid (e.g., commissions, revenue sharing, compensation from affiliates and third parties). State that these investment professionals may have a financial incentive to offer or recommend the Contract over another investment for which the investment professional is not compensated (or compensated less).
(b) Exchanges. State that some investment professionals may have a financial incentive to offer a contractowner a new contract in place of the one he or she already owns, and that a contractowner should only exchange his or her contract if he or she determines, after comparing the features, fees, and risks of both contracts, that it is preferable for him or her to purchase the new contract rather than continue to own the existing contract.
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Instruction. A Registrant may omit these line-items if neither the Registrant nor any of its related companies pay financial intermediaries for the sale of the Contract or related services.
Item 4. Fee Table
Include the following information:
The following tables describe the fees and expenses that you will pay when buying, owning, and surrendering the contract. Please refer to your contract specifications page for information about the specific fees you will pay each year based on the options you have elected. The first table describes the fees and expenses that you will pay at the time that you buy the contract, surrender the contract, or transfer cash value between investment options. State premium taxes may also be deducted.
Annual Transaction Expenses
Sales Load Imposed on Purchases (as a percentage of purchase payments) %
Deferred Sales Load (or Surrender Charge) (as a percentage of purchase payments or amount surrendered, as applicable) %
Exchange Fee %
The next table describes the fees and expenses that you will pay each year during the time that you own the contract (not including [Portfolio Company] fees and expenses). If you choose to purchase an optional benefit, you will pay additional charges, as shown below.
Annual Contract Expenses
Administrative [Expenses] %
Base Contract [Expenses] (as a percentage of average account value) %
Optional Benefit [Expenses] (as a percentage of benefit base or other (e.g., average account value)) %
The next item shows the minimum and maximum total operating expenses charged by the portfolio companies that you may pay periodically during the time that you own the contract. A complete list of [Portfolio Companies] available under the Contract, including their annual expenses, may be found at the back of this document.
Total Annual [Portfolio Company] Operating Expenses Minimum Maximum (expenses that are deducted from [Portfolio Company] assets, including management fees, distribution [and/or ________% ________% service] (12b-1) fees, and other expenses)
Example
This Example is intended to help you compare the cost of investing in the contract with the cost of investing in other variable annuity contracts. These costs include transaction expenses, annual contract expenses, and [Portfolio Company] operating expenses. The Example assumes that you invest $100,000 in the contract for the time periods indicated. The Example also assumes that your investment has a 5% return each year and assumes the most expensive combination of [Portfolio Company} operating expenses and optional benefits available for an additional charge. Although your actual costs may be higher or lower, based on these assumptions, your costs would be:
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If you surrender your contract at the end of the applicable time period:
1 year 3 years 5 years 10 years
$ $ $ $
If you annuitize at the end of the applicable time period:
1 year 3 years 5 years 10 years
$ $ $ $
If you do not surrender your contract:
1 year 3 years 5 years 10 years
$ $ $ $
Instructions
1. Include the narrative explanations in the order indicated. A Registrant may modify a narrative explanation if the
explanation contains comparable information to that shown.
2. Assume that the annuity contract is owned during the accumulation period for purposes of the table (including the Example). If an annuitant would pay different fees or be subject to different expenses, disclose this in a brief narrative and provide a cross-reference to those portions of the prospectus describing these fees.
3. A Registrant may omit captions if the Registrant does not charge the fees or expenses covered by the captions. A Registrant may modify or add captions if the captions shown do not provide an accurate description of the Registrant’s fees and expenses.
4. Round all dollar figures to the nearest dollar and all percentages to the nearest hundredth of one percent.
5. In the Annual Transaction Expenses and Annual Contract Expenses tables, the Registrant must disclose the maximum guaranteed charge, unless a specific instruction directs otherwise. If a fee is calculated based on a benchmark (e.g., a fee that varies according to volatility levels or Treasury yields), the Registrant must also disclose the maximum guaranteed charge as a single number. The Registrant may disclose the current charge, in addition to the maximum charge, if the disclosure of the current charge is no more prominent than, and does not obscure or impede understanding of, the disclosure of the maximum charge. In addition, the Registrant may include in a footnote to the table a tabular, narrative, or other presentation providing further detail regarding variations in the charge. For example, if deferred sales charges decline over time, the Registrant may include in a footnote a presentation regarding the scheduled reductions in the deferred sales charges.
6. Provide a separate fee table (or separate column within the table) for each Contract form offered by the prospectus that has different fees.
7. In a Contract with more than one class, provide a separate response for each class.
Administrative [Expenses]
8. Administrative expenses include any contract, account, or similar fee imposed on all Contractowner Accounts on any recurring basis.
Annual Transaction [Expenses]
9. “Sales Load Imposed on Purchases” includes the maximum sales load imposed upon purchase payments and may include a
tabular presentation, within the larger table, of the range of such sales loads.
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10. “Deferred Sales Load” includes the maximum contingent deferred sales load (or surrender charge), expressed as a percentage of the original purchase price or amount surrendered, and may include a tabular presentation, within the larger table, of the range of contingent deferred sales loads over time.
11. “Exchange Fee” includes the maximum fee charged for any exchange or transfer of contract value from the Registrant to another investment company or from one sub-account of the Registrant to another sub-account or the insurance company’s general account. The Registrant may include a tabular presentation of the range of exchange fees unless such a presentation would be so lengthy as to encumber the larger table, in which case the Registrant should only provide a cross-reference to the narrative portion of the prospectus discussing the exchange fee.
12. If the Registrant (or any other party pursuant to an agreement with the Registrant) charges any other transaction fee, add another caption describing it and list the (maximum) amount or basis on which the fee is deducted.
Base Contract [Expenses]
13. Base Contract expenses includes mortality and expense risk fees, and account fees and expenses. Account fees and
expenses include all fees and expenses (except sales loads, mortality and expense risk fees, and optional benefits expenses) that are deducted from separate account assets or charged to all Contractowner Accounts.
Other Annual Expenses
14. If the Registrant (or any other party pursuant to an agreement with the Registrant) imposes any other recurring charge
(other than Total Annual [Portfolio Company] Operating Expenses), add another caption describing it and list the (maximum) amount or basis on which the charge is deducted.
Optional Benefits [Expenses]
15. Optional Benefits expenses include any optional features (e.g., enhanced death benefits and living benefits) offered under
the Contract for an additional charge.
Total Annual [Portfolio Company] Operating Expenses
16. If a Registrant offers multiple Portfolio Companies, it should disclose the minimum and maximum “Total Annual [Portfolio Company] Operating Expenses” for any Portfolio Company calculated in accordance with Item 3 of Form N-1A (before expense reimbursements or fee waiver arrangements).
17. A Registrant may also reflect minimum and maximum Total [Portfolio Company] Operating Expenses that include expense reimbursement or fee waiver arrangements in an additional line-item to the range of Portfolio Company operating expenses. If the Registrant provides this disclosure, also disclose the period for which the expense reimbursement or fee waiver arrangement is expected to continue, and, if applicable, that it can be terminated at any time at the option of a Portfolio Company.
Example
18. For purposes of the Example(s) in the table, provide the following for each contract class:
(a) Assume that the percentage amounts listed under “Base Contract [Expenses]” remain the same in each year of the 1-,
3-, 5, and 10-year periods;
(b) The most expensive combination of contract features must be shown first. Additional expense presentations are permitted, but not required;
(c) Assume the maximum sales load that may be deducted from purchase payments is deducted;
(d) For any breakpoint in any fee, assume that the amount of the Registrant’s (and the Portfolio Company’s) assets remains constant as of the level at the end of the most recently completed fiscal year;
(e) Assume no exchanges or other transactions;
(f) Reflect any [annual] contract expenses by dividing the total amount of [annual] contract expenses collected during the year that are attributable to the contract offered by the prospectus by the total average net assets that are attributable to
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the contract offered by the prospectus. Add the resulting percentage to Base Contract expenses and assume that it remains the same in each year of the 1-, 3-, 5-, and 10-year periods;
(g) Reflect any contingent deferred sales load by assuming a complete surrender on the last day of the year;
(h) Provide the information required in the third section of the Example only if a sales load or other fee is charged upon a complete surrender; and
(i) Include in the Example the information provided by the caption “If you annuitize at the end of the applicable time period” only if the Registrant charges fees upon annuitization that are different from those charged upon surrender.
Item 5. Principal Risks of Investing in the Contract Summarize the principal risks of purchasing a Contract, including the risks of poor investment performance, that Contracts are unsuitable as short-term savings vehicles, limitations on access to cash value through withdrawals, and the possibility of adverse tax consequences.
Item 6. General Description of Registrant, Depositor, and Portfolio Companies
Concisely discuss the organization and operation or proposed operation of the Registrant. Include the information specified below.
(a) Depositor. Provide the name and address of the Depositor.
(b) Registrant. Briefly describe the Registrant. Include a statement indicating that:
(1) income, gains, and losses credited to, or charged against, the Registrant reflect the Registrant’s own investment experience and not the investment experience of the Depositor’s other assets;
(2) the assets of the Registrant may not be used to pay any liabilities of the Depositor other than those arising from the Contracts; and
(3) the Depositor is obligated to pay all amounts promised to contractowners under the Contracts.
(c) Portfolio Companies. State that information regarding each Portfolio Company, including (i) its name, (ii) its type (e.g., money market fund, bond fund, balanced fund, etc.) or a brief statement concerning its investment objectives, (iii) its investment adviser and any sub-investment adviser, (iv) expense ratio, and (v) performance is available in the appendix to the prospectus (see Item 18), and provide cross-references. State conspicuously that each Portfolio Company has issued a prospectus that contains more detailed information about the Portfolio Company, and provide instructions regarding how investors may obtain paper or electronic copies.
(d) Voting. Concisely discuss the rights of contractowners to instruct the Depositor on the voting of shares of the Portfolio Companies, including the manner in which votes will be allocated.
Item 7. Charges
(a) Description. Briefly describe all charges deducted from purchase payments, Contractowner Accounts, or assets of the
Registrant, or any other source (e.g., sales loads, premium taxes and other taxes, administrative and transaction charges, risk charges, contract loan charges, and optional benefit charges). Indicate whether each charge will be deducted from purchase payments, Contractowner Accounts, or the Registrant’s assets, the proceeds of withdrawals or surrenders, or some other source. When possible, specify the amount of any current charge as a percentage or dollar figure (e.g., 0.95% of average daily net assets or $5 per exchange). For recurring charges, specify the frequency of the deduction (e.g., daily, monthly, annually). Identify the person who receives the amount deducted, briefly explain what is provided in consideration for the charges, and explain the extent to which any charge can be modified. Where it is possible to identify what is provided in consideration for a particular charge (e.g., use of sales load to pay distribution costs), please explain what is provided in consideration for that charge separately.
Instructions.
1. Describe the sales loads applicable to the Contract and how sales loads are charged and calculated, including the factors
affecting the computation of the amount of the sales load. If the Contract has a front-end sales load, describe the sales load as a percentage of the applicable measure of purchase payments and as a percentage of the net amount invested for each breakpoint. For Contracts with a deferred sales load, describe the sales load as a percentage of the applicable measure of
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purchase payments (or other basis) that the deferred sales load may represent. Percentages should be shown in a table. Identify any events on which a deferred sales load is deducted (e.g., surrender or partial surrender). The description of any deferred sales load should include how the deduction will be allocated among sub-accounts of the Registrant and when, if ever, the sales load will be waived (e.g., if the Contract provides a free withdrawal amount).
2. Unless set forth in response to Instruction 1, list any special purchase plans or methods established pursuant to a rule or an exemptive order that reflect scheduled variations in, or elimination of, the sales load (e.g., group discounts, waiver of sales load upon annuitization or attainment of a certain age, waiver of deferred sales load for a certain percentage of contract value (“free corridor”), investment of proceeds from another policy, exchange privileges, employee benefit plans, or the terms of a merger, acquisition or exchange offer made pursuant to a plan of reorganization); identify each class of individuals or transactions to which such plans apply; state each different sales charge available as a percentage of the public offering price and as a percentage of the net amount invested; and state from whom additional information may be obtained. Describe any other special purchase plans or methods established pursuant to a rule that reflect other variations in, or elimination of, the sales load or in any administrative charge or other deductions from purchase payments, and generally describe the basis for the variation or elimination in the sales load or other deduction (i.e., the size of the purchaser, a prior or existing relationship with the purchaser, the purchaser’s assumption of certain administrative functions, or other characteristics that result in differences in costs or services).
3. If proceeds from sales loads will not cover the expected costs of distributing the contracts, identify from what source the shortfall, if any, will be paid. If any shortfall is to be made from assets from the depositor’s general account, disclose, if applicable, that any amounts paid by the depositor may consist, among other things, of proceeds derived from Base Contract Expenses deducted from the account.
4. If the Contract’s charge for premium or other taxes varies according to jurisdiction, identification of the range of current premium or other taxes is sufficient.
(b) Commissions Paid to Dealers. State the commissions paid to dealers as a percentage of purchase payments.
(c) Portfolio Company Charges. State that charges are deducted from and expenses paid out of the assets of the Portfolio
Companies that are described in the prospectuses for those companies.
(d) Operating Expenses. Describe the type of operating expenses for which the Registrant is responsible. If organizational expenses of the Registrant are to be paid out of its assets, explain how the expenses will be amortized and the period over which the amortization will occur.
Item 8. General Description of Contracts
(a) Contract Rights. Identify the person or persons (e.g., the contractowner, participant, annuitant, or beneficiary) who have
material rights under the Contracts, and the nature of those rights, (1) during the accumulation period, (2) during the annuity period, or (3) after the death of the annuitant or contractowner.
Instruction. Disclose all material state variations and intermediary-specific variations (e.g., variations resulting from different brokerage channels) to the offering.
(b) Contract Provisions and Limitations. Briefly describe any provisions and limitations for:
(1) minimum contract value, and the consequences of falling below that amount;
(2) allocation of purchase payments among sub-accounts of the Registrant;
(3) transfer of contract value between sub-accounts of the Registrant, including transfer programs (e.g., dollar cost averaging,
portfolio rebalancing, asset allocation programs, and automatic transfer programs);
(4) conversion or exchange of Contracts for another contract, including a fixed or variable annuity or life insurance contract; and
Instruction. In discussing conversion or exchange of Contracts, the Registrant should include any time limits on conversion or exchange, the name of the company issuing the other contract and whether that company is affiliated with the issuer of the Contract, and how the cash value of the Contract will be affected by the conversion or exchange.
(5) buyout offers of variable annuity contracts, including interests or participations therein.
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(c) General Account. Describe the obligations under the contract that are funded by the insurer’s general account (e.g., death benefits, living benefits, or other benefits available under the contract), and state that these amounts are subject to the insurer’s claims-paying ability and financial strength.
(d) Contract or Registrant Changes. Briefly describe the changes that can be made in the Contracts or the operations of the
Registrant by the Registrant or the Depositor, including:
(1) why a change may be made (e.g., changes in applicable law or interpretations of law);
(2) who, if anyone, must approve any change (e.g., the contractowner or the Commission); and
(3) who, if anyone, must be notified of any change. Instruction. Describe only those changes that would be material to a purchaser of the Contracts, such as a reservation of the right to deregister the Registrant under the Investment Company Act or to substitute one Portfolio Company for another pursuant to section 26(c) of the Investment Company Act. Do not describe possible non-material changes, such as changing the time of day at which accumulation unit values are determined.
(e) Class of Purchasers. Disclose any limitations on the class or classes of purchasers to whom the Contract is being offered.
(f) Frequent Transfers among Sub-accounts of the Registrant.
(1) Describe the risks, if any, that frequent transfers of contract value among sub-accounts of the Registrant may present for
other contractowners and other persons (e.g., participants, annuitants, or beneficiaries) who have material rights under the Contract.
(2) State whether or not the Registrant or Depositor has adopted policies and procedures with respect to frequent transfers of
contract value among sub-accounts of the Registrant.
(3) If neither the Registrant nor the Depositor has adopted any such policies and procedures, provide a statement of the specific basis for the view of the Depositor that it is appropriate for the Registrant and Depositor not to have such policies and procedures.
(4) If the Registrant or Depositor has any such policies and procedures, describe those policies and procedures, including:
(i) whether or not the Registrant or Depositor discourages frequent transfers of contract value among sub-accounts of the Registrant;
(ii) whether or not the Registrant or Depositor accommodates frequent transfers of contract value among sub-accounts of
the Registrant; and
(iii) any policies and procedures of the Registrant or Depositor for deterring frequent transfers of contract value among sub-accounts of the Registrant, including any restrictions imposed by the Registrant or Depositor to prevent or minimize frequent transfers. Describe each of these policies, procedures, and restrictions with specificity. Indicate whether each of these restrictions applies uniformly in all cases or whether the restriction will not be imposed under certain circumstances, including whether each of these restrictions applies to trades that occur through omnibus accounts at intermediaries, such as investment advisers, broker-dealers, transfer agents, and third party administrators. Describe with specificity the circumstances under which any restriction will not be imposed. Include a description of the following restrictions, if applicable:
(A) any restrictions on the volume or number of transfers that may be made within a given time period;
(B) any transfer fee;
(C) any costs or administrative or other fees or charges that are imposed on persons deemed to be engaged in frequent
transfers of contract value among sub-accounts of the Registrant, together with a description of the circumstances under which such costs, fees, or charges will be imposed;
(D) any minimum holding period that is imposed before a transfer may be made from a sub-account into another sub-account of the Registrant;
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(E) any restrictions imposed on transfer requests submitted by overnight delivery, electronically, or via facsimile or telephone; and
(F) any right of the Registrant or Depositor to reject, limit, delay, or impose other conditions on transfers or to terminate or otherwise limit Contracts based on a history of frequent transfers among sub-accounts, including the circumstances under which such right will be exercised.
(5) If applicable, include a statement, adjacent to the disclosure required by paragraphs (f)(i) through (f)(iv) of this Item, that
the Statement of Additional Information includes a description of all arrangements with any person to permit frequent transfers of contract value among sub-accounts of the Registrant.
Item 9. Annuity Period
Briefly describe the annuity options available. The discussion should include:
(a) Material factors that determine the level of annuity benefits;
(b) The annuity commencement date (give the earliest and latest possible dates);
(c) Frequency and duration of annuity payments, and the effect of these on the level of payment;
(d) The effect of assumed investment return;
(e) Any minimum amount necessary for an annuity option and the consequences of an insufficient amount; and
(f) Rights, if any, to change annuity options or to effect a transfer of investment base after the annuity commencement date. Instructions:
1. Describe the choices, if any, available to a prospective annuitant, and the effect of not specifying a choice. Where an
annuitant is given a choice in assumed investment return, explain the effect of choosing a higher, as opposed to a lower, assumed investment return.
2. Detailed disclosure on the method of calculating annuity payments should be placed in the SAI in response to Item 25.
(g) If applicable, state that the contractowner will not be able to withdraw any contract value amounts after the annuity commencement date.
Item 10. Standard Death Benefit
Briefly describe the standard death benefit provided under the Contract during the accumulation and the annuity periods. Include:
(a) The operation of the standard death benefit, including the amount of the death benefit and how the death benefit amount may
vary, the circumstances under which the value of the benefit may increase or be reduced (including the impact of withdrawals), and how the benefit may be terminated.
(b) When the death benefit is calculated and payable and the effect of choosing a specific method of payment on calculation of the death benefit.
(c) The forms the benefit may take, including the effect of not choosing a payment option and the period, if any, during which payments must begin under any annuity option.
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Item 11. Other Benefits Available Under the Contract
(a) Include the following information: In addition to the standard death benefit associated with your contract, other [standard and/or optional] benefits may also be available to you. The purposes, fees, and restrictions/limitations of these additional benefits are briefly summarized in the following table[s].
Name of Benefit Purpose Statement of Whether Benefit Is Standard or Optional
Fee Brief Description of Restrictions/ Limitations
[ ]%
[ ]%
Instructions.
1. General.
(a) The table required by this Item 11(a) is meant to provide a tabular summary overview of the benefits described in Item
11(b) (e.g., optional death benefits, optional or standard living benefits, etc.)
(b) If the Contract offers multiple benefits of the same type (e.g., death benefit, accumulation benefit, withdrawal benefit, long-term care benefit), the Registrant may include multiple tables in response to this Item 11(a), if doing so might better permit comparisons of different benefits of the same type.
(c) The Registrant should include appropriate titles, headings, or any other information to promote clarity and facilitate understanding of the table(s) presented in response to this Item 11(a). For example, if certain optional benefits are only available to certain contractowners (e.g., contractowners who invested during specific time periods), the table could include footnotes or headings to identify which optional benefits are affected and to whom those optional benefits are available. In addition, if the Registrant includes titles or headings for the table(s) specifying whether the benefit is standard or optional, the Registrant does not need to include the “Statement of Whether Benefit is Standard or Optional” column in the table(s).
2. Name of Benefit. State the name of each benefit included in the table(s).
3. Purpose. Briefly describe the purpose of each benefit included in the table(s).
4. Statement of Whether Benefit Is Standard or Optional. State whether the benefit is standard or optional.
5. Fee. State the fee associated with each benefit included in the table(s). Include parentheticals providing information about
what the stated percentage refers to (e.g., percentage of contract value, percentage of benefit base, etc.).
6. Brief Description of Restrictions/Limitations. For each benefit for which the Registrant has stated that there are restrictions or limitations, briefly describe the restriction(s) or limitation(s) associated with each benefit. Registrants are encouraged to use short phrases (e.g., “benefit limits investment options available,” “withdrawals could terminate benefit”) to describe the restriction(s) or limitation(s).
(b) Briefly describe any other benefits (other than standard death benefit, e.g., optional death benefits, optional or standard living
benefits, etc.) offered under a Contract, including:
(1) Whether the benefit is standard or elected;
(2) The operation of the benefit, including the amount of the benefit and how the benefit amount may vary, the circumstances under which the value of the benefit may increase or be reduced (including the impact of withdrawals), and how the benefit may be terminated;
(3) Fees and costs, if any, associated with the benefit; and
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(4) How the benefit amount is calculated and payable and the effect of choosing a specific method of payment on calculation of the benefit.
(c) Briefly describe any limitations, restrictions and risks associated with any benefit (other than the standard death benefit) offered
under the contract (e.g., restrictions on which Portfolio Companies may be selected; risk of reduction or termination of benefit resulting from excess withdrawals).
Instruction. In responding to paragraphs (b) and (c) of this Item, provide one or more examples illustrating the operation of each benefit in a clear, concise, and understandable manner.
Item 12. Purchases and Contract Value
(a) Briefly describe the procedures for purchasing a Contract. Include a concise explanation of:
(1) the minimum initial and subsequent purchase payments required and any limitations on the amount of purchase payments that will be accepted (if there are separate limits for each sub-account, state these limits); and
(2) a statement of when initial and subsequent purchase payments are credited.
(b) Describe the manner in which purchase payments are credited, including: (A) an explanation that purchase payments are credited on the basis of accumulation unit value; (B) how accumulation unit value is determined; and (C) how the number of accumulation units credited to a contract is determined.
(c) Explain that investment performance of the Portfolio Companies, expenses, and deduction of certain charges affect accumulation unit value and/or the number of accumulation units.
(d) Describe when calculations of accumulation unit value are made and that purchase payments are credited to a contract on the basis of accumulation unit value next determined after receipt of a purchase payment.
(e) Identify each principal underwriter (other than the depositor) of the variable annuity contracts and state its principal business address. If the principal underwriter is affiliated with the Registrant, the depositor, or any affiliated person of the Registrant or the depositor, identify how they are affiliated (e.g., the principal underwriter is controlled by the depositor).
Item 13. Surrenders and Withdrawals
(a) Surrender. Briefly describe how a contractowner or annuitant (if the annuity option chosen by the annuitant is not based on a
life contingency) can surrender (or partially surrender or make withdrawals from) a Contract, including any limits on the ability to surrender, how the proceeds are calculated, and when they are payable.
(b) Partial Surrender and Withdrawal. Indicate generally whether and under what circumstances partial surrenders and partial withdrawals are available under a Contract, including the minimum and maximum amounts that may be surrendered or withdrawn, any limits on their availability, how the proceeds are calculated, and when the proceeds are payable.
(c) Effect of Partial Surrender and Withdrawal. Indicate generally whether and under what circumstances partial surrenders or partial withdrawals will affect a Contract’s cash value, death benefit(s), and/or any living benefits, and whether any charge(s) will apply.
(d) Sub-Account Allocation. Describe how partial surrenders and partial withdrawals will be allocated to the sub-accounts. Instruction. The Registrant should generally describe the terms and conditions that apply to these transactions. Technical information regarding the determination of amounts available to be surrendered or withdrawn should be included in the SAI.
(e) Involuntary Redemption. Briefly describe any provision for involuntary redemptions under the Contract and the reasons for it,
such as the size of the account or infrequency of purchase payments.
(f) Revocation Rights. Briefly describe any revocation rights (e.g., “free look” provisions), including a description of how the amount refunded is determined, the method for crediting earnings to purchase payments during the free look period, and whether investment options are limited during the free look period.
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Item 14. Loans Briefly describe the loan provisions of the Contract, including any of the following that are applicable.
(a) Availability of Loans. State that a portion of the Contract’s cash surrender value may be borrowed. State how the amount
available for a loan is calculated.
(b) Limitations. Describe any limits on availability of loans (e.g., a prohibition on loans during the first Contract year).
(c) Interest. Describe how interest accrues on the loan, when it is payable, and how interest is treated if not paid. Explain how interest earned on the loaned amount is credited to the Contract and allocated to the sub-accounts.
(d) Effect on Contract Value and Death Benefit. Describe how loans and loan repayments affect cash value and how they are allocated among the sub-accounts. Include (i) a brief explanation that amounts borrowed under a Contract do not participate in a Registrant’s investment experience and that loans, therefore, can affect the Contract’s value and death benefit whether or not the loan is repaid, and (ii) a brief explanation that the cash surrender value and the death proceeds payable will be reduced by the amount of any outstanding Contract loan plus accrued interest.
(e) Other Effects. Describe any other effect that a loan could have on the Contract (e.g., the effect of a Contract loan in excess of contract value).
(f) Procedures. Describe the loan procedures, including how and when amounts borrowed are transferred out of the Registrant and how and when amounts repaid are credited to the Registrant.
Item 15. Taxes
(a) Tax Consequences. Describe the material tax consequences to the contractowner and beneficiary of buying, holding,
exchanging, or exercising rights under the Contract. Instruction. Discuss the taxation of annuity payments, death benefit proceeds, periodic and non-periodic withdrawals, loans, and any other distribution that may be received under the Contract, as well as the tax benefits accorded the Contract, and other material tax consequences. Describe, if applicable, whether the tax consequences vary with different uses of the Contract.
(b) Qualified Plans. Identify the types of qualified plans for which the Contracts are intended to be used. Instructions:
1. Identify the types of persons who may use the plans (e.g., corporations, self-employed individuals) and disclose, if
applicable, that the terms of the plan may limit the rights otherwise available under the contracts.
2. Do not describe the Internal Revenue Code requirements for qualifications of plans or the non-annuity tax consequences of qualification (e.g., the effect on employer taxation).
(c) Effect. Describe the effect, if any, of taxation on the determination of cash values or sub-account values.
Item 16. Legal Proceedings
Describe any material pending legal proceedings, other than ordinary routine litigation incidental to the business, to which the Registrant, the Registrant’s principal underwriter or the Depositor is a party. Include the name of the court where the case is pending, the date instituted, the principal parties involved, a description of the factual basis alleged to underlie the proceeding, and the relief sought. Include similar information as to any proceedings instituted, or known to be contemplated, by a governmental authority. Instruction. For purposes of this requirement, legal proceedings are material only to the extent that they are likely to have a material adverse effect on the Registrant, the ability of the principal underwriter to perform its contract with the Registrant, or the ability of the Depositor to meet its obligations under the Contracts.
Item 17. Financial Statements
If all of the required financial statements of the Registrant and the Depositor (see Item 26 and General Instruction C.3(b)) are not in the prospectus, state, under a separate caption, where the financial statements may be found. Briefly explain how investors may obtain any financial statements not in the Statement of Additional Information.
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Item 18. Portfolio Companies Available Under the Contract
Include as an Appendix under the heading “Appendix: [Portfolio Companies] Available Under [the Contract]” the following information, in the format specified below: The following is a list of [Portfolio Companies] currently available under [the Contract], which is subject to change as discussed in [the Statutory Prospectus for the Contract]. Before you invest, you should review the prospectuses for the [Portfolio Companies]. These prospectuses contain more information about the [Portfolio Companies] and their risks and may be amended from time to time. You can find the prospectuses and other information about the [Portfolio Companies] online at [___]. You can also request this information at no cost by calling [____] or by sending an email request to [___]. The performance information below reflects fees and expenses of the [Portfolio Companies], but does not reflect the other fees and expenses that your contract may charge. Performance would be lower if these charges were included. Each [Portfolio Company’s] past performance is not necessarily an indication of future performance.
[Type / Investment Objective]
[Portfolio Company and
Adviser / Subadviser]
Expense Ratio (expenses/
average assets)
Average Annual Total Returns
(as of 12/31/_)
1 year 5 year 10 year
[Insert] [Names of Portfolio
Company and adviser /
subadviser]
[_]% [_]% [_]% [_]%
Instructions.
1. General.
(a) Only include those Portfolio Companies that are currently offered under the Contract.
(b) The introductory legend to the table must provide a website address, other than the address of the Commission’s
electronic filing system; toll free telephone number; and email address that investors can use to obtain the prospectuses of the Portfolio Companies and to request other information about the Portfolio Companies. The website address must be specific enough to lead investors directly to the prospectuses of the Portfolio Companies, rather than to the home page or other section of the website on which the materials are posted. The website could be a central site with prominent links to each document. The legend may indicate, if applicable, that the prospectuses and other information are available from a financial intermediary (such as an insurance sales agent or broker-dealer) through which the Contract may be purchased or sold. Registrants not relying upon rule 498A(j) under the Securities Act [17 CFR 230.498A(j)] with respect to the Portfolio Companies that are offered under the Contract may, but are not required to, provide the next-to-last sentence of the first paragraph of the introductory legend to the table regarding online availability of the prospectuses.
(c) If the availability of one or more Portfolio Companies varies by benefit offered under the Contract, include as another Appendix a separate table that indicates which Portfolio Companies are available under each of the benefits offered under the Contract. This Appendix could incorporate a table that is structured pursuant to the following example, or could use any other presentation that might promote clarity and facilitate understanding:
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[Portfolio Company] [Benefit #1] [Benefit #2] [Benefit #3] [Benefit #4]
Portfolio Company A
Portfolio Company B
Portfolio Company C
Portfolio Company D
2. Type/Investment Objective. Briefly describe each Portfolio Company’s type (e.g., money market fund, bond fund,
balanced fund, etc.), or include a brief statement concerning the Portfolio Company’s investment objectives.
3. Portfolio Company and Adviser/Subadviser. State the name of each Portfolio Company and its adviser/subadviser, as applicable. The adviser’s/sub-adviser’s name may be omitted if it is incorporated into the name of the Portfolio Company.
4. Expense ratio. For purposes of this Item 18, “expense ratio” means “Total Annual Fund Operating Expenses” as calculated pursuant to Item 3 of Form N-1A for open-end funds, before waivers and reimbursements that reduce the Portfolio Company’s rate of return.
5. Average Annual Total Returns. For purposes of this Item 18, “average annual total returns” means the “average annual total return” (before taxes) as calculated pursuant to Item 4(b)(2)(iii) of Form N-1A for open-end funds.
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PART B - INFORMATION REQUIRED IN A STATEMENT OF ADDITIONAL INFORMATION
Item 19. Cover Page and Table of Contents
(a) Front Cover Page. Include the following information on the outside front cover page of the SAI: (1) The Registrant’s name. (2) The Depositor’s name. (3) The name of the Contract and the Class or Classes, if any, to which the Contract relates. (4) A statement or statements:
(i) That the SAI is not a prospectus;
(ii) How the prospectus may be obtained; and
(iii) Whether and from where information is incorporated by reference into the SAI, as permitted by General Instruction D.
Instruction. Any information incorporated by reference into the SAI must be delivered with the SAI. (5) The date of the SAI and the prospectus to which the SAI relates.
(b) Table of Contents. Include under appropriate captions (and subcaptions) a list of the contents of the SAI and, when useful, provide cross references to related disclosure in the prospectus.
Item 20. General Information and History
(a) Depositor. Provide the date and form of organization of the Depositor, the name of the state or other jurisdiction in which the
Depositor is organized, and a description of the general nature of the Depositor’s business. Instruction. The description of the Depositor’s business should be short and need not list all of the businesses in which the Depositor engages or identify the jurisdictions in which it does business if a general description (e.g., “variable annuity” or “reinsurance”) is provided. (b) Registrant. Provide the date and form of organization of the Registrant and the Registrant’s classification pursuant to Section 4
[15 U.S.C. 80a-4] (i.e., a separate account and a unit investment trust). (c) History of Depositor and Registrant. If the Depositor’s name was changed during the past five years, state its former name and
the approximate date on which it was changed. If, at the request of any state, sales of contracts offered by the Registrant have been suspended at any time, or if sales of contracts offered by the Depositor have been suspended during the past five years, briefly describe the reasons for and results of the suspension. Briefly describe the nature and results of any bankruptcy, receivership, or similar proceeding, or any other material reorganization, readjustment, or succession of the Depositor during the past five years.
(d) Ownership of Sub-Account Assets. If 10 percent or more of the assets of any sub-account are not attributable to Contracts or to
accumulated deductions or reserves (e.g., initial capital contributed by the Depositor), state what percentage those assets are of the total assets of the Registrant. If the Depositor, or any other person controlling the assets, has any present intention of removing the assets from the sub-account, so state.
(e) Control of Depositor. State the name of each person who controls the Depositor and the nature of its business. Instruction. If the Depositor is controlled by another person that, in turn, is controlled by another person, give the name of each control person and the nature of its business.
Item 21. Services
(a) Expenses Paid by Third Parties. Describe all fees, expenses, and costs of the Registrant that are to be paid by persons other
than the Depositor or the Registrant, and identify those persons.
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(b) Service Agreements. Summarize the substantive provisions of any management-related service contract that may be of interest to a purchaser of the Registrant’s securities, under which services are provided to the Registrant, unless the contract is described in response to some other item of the form. Indicate the parties to the contract, and the total dollars paid and by whom for each of the past three years.
Instructions:
1. The term “management-related service contract” includes any contract with the Registrant to keep, prepare, or file
accounts, books, records, or other documents required under federal or state law, or to provide any similar services with respect to the daily administration of the Registrant, but does not include the following:
(a) Any agreement with the Registrant to act as custodian or agent to administer purchases and redemptions under the
Contracts, and (b) Any contract with the Registrant for outside legal or auditing services, or contract for personal employment entered
into with the Registrant in the ordinary course of business.
2. In summarizing the substantive provisions of any management-related service contract, include the following:
(a) The name of the person providing the service; (b) The direct or indirect relationships, if any, of the person with the Registrant, its Depositor, or its principal underwriter;
and (c) The nature of the services provided; and the basis of the compensation paid for the services for the Registrant’s last
three fiscal years.
(c) Other Service Providers.
(1) Unless disclosed in response to paragraph (b) or another item of this form, identify and state the principal business address of any person who provides significant administrative or business affairs management services for the Registrant (e.g., an “Administrator,” “Sub-Administrator,” “Servicing Agent”), describe the services provided, and the compensation paid for the services.
(2) State the name and principal business address of the Registrant’s custodian and independent public accountant and describe generally the services performed by each.
(3) If the Registrant’s assets are held by a person other than the Depositor, a commercial bank, trust company, or depository registered with the Commission as custodian, state the nature of the business of each such person.
(4) If an affiliated person of the Registrant or the Depositor, or an affiliated person of such an affiliated person, acts as administrative or servicing agent for the Registrant, describe the services the person performs and the basis for remuneration. State, for the past three years, the total dollars paid for the services, and by whom.
Instruction. No disclosure need be given in response to paragraph (c)(4) of this Item for an administrative or servicing agent who is also the Depositor.
(5) If the Depositor is the principal underwriter of the Contracts, so state.
Item 22. Purchase of Securities Being Offered
(a) Describe the manner in which Registrant’s securities are offered to the public. Include a description of any special purchase
plans and any exchange privileges not described in the prospectus. Instruction. Address exchange privileges between sub-accounts, between the Registrant and other separate accounts, and between the Registrant and contracts offered through the depositor’s general account.
(b) Describe the method that will be used to determine the sales load on the variable annuity contracts offered by the Registrant. Instruction. Explain fully any difference in the price at which variable annuity contracts are offered to members of the public, as individuals or as groups, and the prices at which the contracts are offered for any class of transactions or to any class of individuals,
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including officers, directors, members of the board of managers, or employees of the Registrant’s depositor, underwriter, Portfolio Company, or investment adviser to the Portfolio Company.
(c) Frequent Transfer Arrangements. Describe any arrangements with any person to permit frequent transfers of contract value
among sub-accounts of the Registrant, including the identity of the persons permitted to engage in frequent transfers pursuant to such arrangements, and any compensation or other consideration received by the Registrant, the depositor, or any other party pursuant to such arrangements.
Instructions:
1. The consideration required to be disclosed by Item 22(c) includes any agreement to maintain assets in the Registrant or in
other investment companies or accounts managed or sponsored by the Depositor, any investment adviser of a Portfolio Company, or any affiliated person of the Depositor or of any such investment adviser.
2. If the Registrant has an arrangement to permit frequent transfers of contract value among sub-accounts of the Registrant by
a group of individuals, such as the participants in a defined contribution plan that meets the requirements for qualification under Section 401(k) of the Internal Revenue Code (26 U.S.C. 401(k)), the Registrant may identify the group rather than identifying each individual group member.
Item 23. Underwriters
(a) Identification. Identify each principal underwriter (other than the Depositor) of the Contracts, and state its principal business
address. If the principal underwriter is affiliated with the Registrant, the Depositor, or any affiliated person of the Registrant or the Depositor, identify how they are affiliated (e.g., the principal underwriter is controlled by the Depositor).
(b) Offering and Commissions. For each principal underwriter distributing Contracts of the Registrant, state:
(1) whether the offering is continuous; and
(2) the aggregate dollar amount of underwriting commissions paid to, and the amount retained by, the principal underwriter for each of the Registrant’s last three fiscal years.
(c) Other Payments. With respect to any payments made by the Registrant to an underwriter of or dealer in the Contracts during
the Registrant’s last fiscal year, disclose the name and address of the underwriter or dealer, the amount paid; and basis for determining the amount, the circumstances surrounding the payments, and the consideration received by the Registrant. Do not include information about:
(1) Payments made through deduction from premiums paid at the time of sale of the Contracts; or
(2) Payments made from cash values upon full or partial surrender of the Contracts or from an increase or decrease in the
face amount of the Contracts. Instructions.
1. Information need not be given about the service of mailing proxies or periodic reports of the Registrant.
2. Exclude information about bona fide contracts with the Registrant or its Depositor for outside legal or auditing services, or
bona fide contracts for personal employment entered into with the Registrant or its Depositor in the ordinary course of business.
3. Information need not be given about any service for which total payments of less than $15,000 were made during each of the Registrant’s last three fiscal years.
4. Information need not be given about payments made under any contract to act as administrative or servicing agent.
5. If the payments were made under an arrangement or policy applicable to dealers generally, describe only the arrangement or policy.
Item 24. Calculation of Performance Data
(a) Money Market Funded Sub-Accounts. Yield quotation(s) included in the prospectus for an account or sub-account that holds
itself out as a “money market” account or sub-account should be calculated according to paragraphs (a)(1) - (2).
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(1) Yield Quotation. Based on the 7 days ended on the date of the most recent balance sheet of the Registrant included in the
registration statement, calculate the yield by determining the net change, exclusive of capital changes and income other than investment income, in the value of a hypothetical pre-existing account having a balance of one accumulation unit of the account or sub-account at the beginning of the period, subtracting a hypothetical charge reflecting deductions from Contractowner Accounts, and dividing the difference by the value of the account at the beginning of the base period to obtain the base period return, and then multiplying the base period return by (365/7) with the resulting yield figure carried to at least the nearest hundredth of one percent.
(2) Effective Yield Quotation. Based on the 7 days ended on the date of the most recent balance sheet of the Registrant included in the registration statement, calculate the effective yield, carried to at least the nearest hundredth of one percent, by determining the net change, exclusive of capital changes and income other than investment income, in the value of a hypothetical pre-existing account having a balance of one accumulation unit of the account or sub-account at the beginning of the period, subtracting a hypothetical charge reflecting deductions from Contractowner Accounts, and dividing the difference by the value of the account at the beginning of the base period to obtain the base period return, and then compounding the base period return by adding 1, raising the sum to a power equal to 365 divided by 7, and subtracting 1 from the result, according to the following formula:
EFFECTIVE YIELD = [(BASE PERIOD RETURN +1)365/7]-1.
Instructions:
1. When calculating the yield or effective yield quotations, the calculation of net change in account value must include all
deductions that are charged to all Contractowner Accounts in proportion to the length of the base period. For any account fees that vary with the size of the account, assume an account size equal to the sub-account’s mean (or median) account size.
2. Deductions from purchase payments and sales loads assessed at the time of redemption or annuitization should not be reflected in the computation of yield and effective yield. However, the amount or specific rate of such deductions must be disclosed.
3. Exclude realized gains and losses from the sale of securities and unrealized appreciation and depreciation from the
calculation of yield and effective yield. Exclude income other than investment income.
(b) Other Sub-Accounts. Performance information included in the prospectus should be calculated according to paragraphs (b)(i) – (iii).
(1) Average Annual Total Return Quotation. For the 1-, 5-, and 10-year periods ended on the date of the most recent balance
sheet of the Registrant included in the registration statement, calculate the average annual total return by finding the average annual compounded rates of return over the 1-, 5-, and 10-year periods that would equate the initial amount invested to the ending redeemable value, according to the following formula:
P(1+T)n = ERV
Where: P = a hypothetical initial payment of $1,000 T = average annual total return n = number of years ERV = ending redeemable value of a hypothetical $1,000 payment made at the beginning of the 1-, 5-, or
10-year periods at the end of the 1-, 5-, or 10- year periods (or fractional portion).
Instructions:
1. Assume the maximum sales load (or other charges deducted from payments) is deducted from the initial $1,000 payment.
2. Include all recurring fees that are charged to all Contractowner Accounts. For any account fees that vary with the size of the account, assume an account size equal to the sub-account’s mean (or median) account size. If recurring fees charged to Contractowner Accounts are paid other than by redemption of accumulation units, they should be appropriately reflected.
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3. Determine the ending redeemable value by assuming a complete redemption at the end of the 1, 5, or 10 year periods and the deduction of all nonrecurring charges deducted at the end of each period.
4. If the Registrant’s registration statement has been in effect less than one, five, or ten years, the time period during which the registration statement has been in effect should be substituted for the period stated.
5. Carry the total return quotation to the nearest hundredth of one percent.
6. Total return information in the prospectus need only be current to the end of the Registrant’s most recent fiscal year.
(2) Yield Quotation. Based on a 30-day (or one month) period ended on the date of the most recent balance sheet of the Registrant included in the registration statement, calculate yield by dividing the net investment income per accumulation unit earned during the period by the maximum offering price per unit on the last day of the period, according to the following formula:
YIELD = 2[( a – b +1)6-1]
cd
Where:
a = net investment income earned during the period by the Portfolio Company attributable to shares owned by the sub-account.
b = expenses accrued for the period (net of reimbursements). c = the average daily number of accumulation units outstanding during the period. d = the maximum offering price per accumulation unit on the last day of the period.
Instructions:
1. Include among the expenses accrued for the period all recurring fees that are charged to all Contractowner Accounts. For any account fees that vary with the size of the account, assume an account size equal to the sub-account’s mean (or median) account size.
2. If a broker-dealer or an affiliate (as defined in paragraph (b) of Rule 1-02 [17 CFR 210.1-02(b) of Regulation S-X) of the broker-dealer has, in connection with directing the Portfolio Company’s brokerage transactions to the broker-dealer, provided, agreed to provide, paid for, or agreed to pay for, in whole or in part, services provided to the Portfolio Company (other than brokerage and research services as these terms are defined in Section 28(e) of the Securities Exchange Act of 1934 [15 U.S.C. 78bb(e)]), add to expenses accrued for the period an estimate of additional amounts that would have been accrued for the period if the Portfolio Company had paid for the services directly in an arms-length transaction.
3. Net investment income must be calculated by the Portfolio Company as prescribed by Item 26(b)(4) of Form N-1A. NOTE: (a-b) = net investment income in the Item 26(b)(4) equation.
4. Disclose the amount or specific rate of any nonrecurring account or sales charges.
(3) Non-Standardized Performance Quotation. A Registrant may calculate performance using any other historical measure of performance (not subject to any prescribed method of computation) if the measurement reflects all elements of return.
Item 25. Annuity Payments
Describe the method for determining the amount of annuity payments if not described in the prospectus. In addition, describe how any change in the amount of a payment after the first payment is determined.
Item 26. Financial Statements
(a) Registrant. Provide financial statements of the Registrant. Instructions. Include, in a separate section, the financial statements and schedules required by Regulation S-X [17 CFR 210]. Financial statements of the Registrant may be limited to:
(i) An audited balance sheet or statement of assets and liabilities as of the end of the most recent fiscal year;
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(ii) An audited statement of operations of the most recent fiscal year conforming to the requirements of Rule 6-07 of
Regulation S-X [17 CFR 210.6-07];
(iii) An audited statement of cash flows for the most recent fiscal year if necessary to comply with generally accepted accounting principles; and
(iv) Audited statements of changes in net assets conforming to the requirements of Rule 6-09 of Regulation S-X [17 CFR 210.6-09] for the two most recent fiscal years.
(b) Depositor. Provide financial statements of the Depositor. Instructions:
1. Include, in a separate section, the financial statements and schedules of the Depositor required by Regulation S-X. If the
Depositor would not have to prepare financial statements in accordance with generally accepted accounting principles except for use in this registration statement or other registration statements filed on Forms N-3, N-4, or N-6, its financial statements may be prepared in accordance with statutory requirements. The Depositor’s financial statements must be prepared in accordance with generally accepted accounting principles if the Depositor prepares financial information in accordance with generally accepted accounting principles for use by the Depositor’s parent, as defined in Rule 1-02(p) of Regulation S-X [17 CFR 210.1-02(p)], in any report under sections 13(a) and 15(d) of the Securities Exchange Act [15 U.S.C. 78m(a) and 78o(d)] or any registration statement filed under the Securities Act.
2. All statements and schedules of the Depositor required by Regulation S-X, except for the consolidated balance sheets described in Rule 3-01 of Regulation S-X [17 CFR 210.3-01], and any notes to these statements or schedules, may be omitted from Part B and instead included in Part C of the registration statement. If any of this information is omitted from Part B and included in Part C, the consolidated balance sheets included in Part B should be accompanied by a statement that additional financial information about the Depositor is available, without charge, upon request. When a request for the additional financial information is received, the Registrant should send the information within 3 business days of receipt of the request, by first-class mail or other means designed to ensure equally prompt delivery.
3. Notwithstanding Rule 3-12 of Regulation S-X [17 CFR 210.3-12], the financial statements of the Depositor need not be more current than as of the end of the most recent fiscal year of the Depositor. In addition, when the anticipated effective date of a registration statement falls within 90 days subsequent to the end of the fiscal year of the Depositor, the registration statement need not include financial statements of the Depositor more current than as of the end of the third fiscal quarter of the most recently completed fiscal year of the Depositor unless the audited financial statements for such fiscal year are available. The exceptions to Rule 3-12 of Regulation S-X contained in this Instruction 3 do not apply when:
(a) The Depositor’s financial statements have never been included in an effective registration statement under the
Securities Act of 1933 of a separate account that offers variable annuity contracts or variable life insurance contracts; or
(b) The balance sheet of the Depositor at the end of either of the two most recent fiscal years included in response to this Item shows a combined capital and surplus, if a stock company, or an unassigned surplus, if a mutual company, of less than $2,500,000; or
(c) The balance sheet of the Depositor at the end of a fiscal quarter within 135 days of the expected date of effectiveness under the Securities Act (or a fiscal quarter within 90 days of filing if the registration statement is filed solely under the Investment Company Act) would show a combined capital surplus, if a stock company, or an unassigned surplus, if a mutual company, of less than $2,500,000. If two fiscal quarters end within the 135 day period, the Depositor may choose either for purposes of this test.
Any interim financial statements required by this Item need not be comparative with financial statements for the same interim period of an earlier year.
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Item 27. Condensed Financial Information Furnish the following information for each class of accumulation units of the Registrant.
ACCUMULATION UNIT VALUES (for an accumulation unit outstanding throughout the period) 1. accumulation unit value at beginning of period; 2. accumulation unit value at end of period; 3. number of accumulation units outstanding at the end of period.
Instructions:
1. For purpose of this Item, “class of accumulation units” means any variation that affects accumulation units, including
variations related to contract class, optional benefits, and sub-accounts.
2. The above information must be provided for each class of accumulation units of the Registrant derived from contracts offered by means of any prospectus (and each class derived from contracts no longer offered for sale) to which the SAI relates, but for which registrant may continue to accept payments. Information need not be provided for any class of accumulation units of the Registrant derived from contracts that are currently offered for sale by means of a different prospectus. Also, information need not be provided for any class of accumulation units that is no longer offered for sale but for which Registrant may continue to accept payments, if the information is provided in a different, but current prospectus of the Registrant.
3. The information shall be presented in comparative columns for each of the last five fiscal years of the Registrant (or for life of the Registrant and its immediate predecessors, if less) but only from the later of the effective date of Registrant’s or the relevant Portfolio Company’s first 1933 Act Registration Statement. In addition, the information shall be presented for the period between the end of the latest fiscal year and the date of the latest balance sheet or statement of assets and liabilities furnished.
4. Accumulation unit amounts shall be given at least to the nearest cent. If the computation of the offering price is extended to tenths of a cent or more, then the amounts on the table should be given in tenths of a cent.
5. Accumulation unit values should only be given for sub-accounts that fund obligations of the Registrant under variable annuity contracts offered by means of this prospectus.
6. Registrants may, but are not required to, omit the AUV tables, if the registrant provides an annual account statement to each individual contractowner that discloses, with respect to each class of accumulation units held by the contractowner, the actual performance of each subaccount reflecting all contract charges incurred by the contractowner. For accounts held less than one year, the annual account statement must disclose the actual performance of each sub-account for the length of time the investor has owned the sub-account.
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PART C - OTHER INFORMATIONItem 28. Exhibits
Subject to General Instruction D regarding incorporation by reference and rule 483 under the Securities Act [17 CFR 230.483], file the exhibits listed below as part of the registration statement. Letter or number the exhibits in the sequence indicated and file copies rather than originals, unless otherwise required by rule 483. Reflect any exhibit incorporated by reference in the list below and identify the previously filed document containing the incorporated material. (a) Board of Directors Resolution. The resolution of the board of directors of the Depositor authorizing the establishment of the
Registrant. (b) Custodian Agreement. All agreements for custody of securities and similar investments of the Registrant, including the
schedule of remuneration. (c) Underwriting Contracts. Underwriting or distribution contract between the Registrant or Depositor and a principal
underwriter and agreements between principal underwriters and dealers or the Depositor and dealers. (d) Contracts. The form of each Contract, including any riders or endorsements. (e) Applications. The form of application used with any Contract provided in response to (d) above; (f) Depositor’s Certificate of Incorporation and By-Laws. The Depositor’s current certificate of incorporation or other instrument
of organization and by-laws and any related amendment. (g) Reinsurance Contracts. Any contract of reinsurance related to a Contract. (h) Participation Agreements. Any participation agreement or other contract relating to the investment by the Registrant in a
Portfolio Company. (i) Administrative Contracts. Any contract relating to the performance of administrative services in connection with administering
a Contract. (j) Other Material Contracts. Other material contracts not made in the ordinary course of business to be performed in whole or in
part on or after the filing date of the registration statement. (k) Legal Opinion. An opinion and consent of counsel regarding the legality of the securities being registered, stating whether the
securities will, when sold, be legally issued and represent binding obligations of the Depositor. (l) Other Opinions. Copies of any other opinions, appraisals, or rulings, and consents of their use relied on in preparing this
Registration Statement and required by Section 7 of the 1933 Act. (m) Omitted Financial Statements. Financial statements omitted from Item 26. (n) Initial Capital Agreement. Any agreements or understandings made in consideration for providing the initial capital between or
among the Registrant, Depositor, underwriter, or initial contractowners and written assurances from the Depositor or initial contractowners that purchases were made for investment purposes and not with the intention of redeeming or reselling.
(o) Preliminary Summary Prospectuses. The form of any Initial Summary Prospectus and Updating Summary Prospectus that the
Registrant intends to use on or after the effective date of the registration statement, pursuant to rule 498A under the Securities Act.
Instruction. Registrants are required to provide the preliminary Summary Prospectus exhibits only in connection with the filing of an initial registration statement, or in connection with a pre-effective amendment or a post-effective amendment filed in accordance with paragraph (a) of rule 485 under the Securities Act.
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Item 29. Directors and Officers of the Depositor
Provide the following information about each director or officer of the Depositor:
Instruction. Registrants are required to provide the above information only for officers or directors who are engaged directly or indirectly in activities relating to the Registrant or the Contracts, and for executive officers including the Depositor’s president, secretary, treasurer, and vice presidents who have authority to act as president in his or her absence. Item 30. Persons Controlled by or Under Common Control with the Depositor or Registrant
Provide a list or diagram of all persons directly or indirectly controlled by or under common control with the Depositor or the Registrant. For any person controlled by another person, disclose the percentage of voting securities owned by the immediately controlling person or other basis of that person’s control. For each company, also provide the state or other sovereign power under the laws of which the company is organized. Instructions:
1. Include the Registrant and the Depositor in the list or diagram and show the relationship of each company to the Registrant
and Depositor and to the other companies named, using cross-references if a company is controlled through direct ownership of its securities by two or more persons.
2. Indicate with appropriate symbols subsidiaries that file separate financial statements, subsidiaries included in consolidated financial statements; or unconsolidated subsidiaries included in group financial statements. Indicate for other subsidiaries why financial statements are not filed.
Item 31. Indemnification
State the general effect of any contract, arrangements, or statute under which any underwriter or affiliated person of the Registrant is insured or indemnified against any liability incurred in his or her official capacity, other than insurance provided by any underwriter or affiliated person for his or her own protection.
Item 32. Principal Underwriters
(a) Other Activity. State the name of each investment company (other than the Registrant) for which each principal underwriter
currently distributing the Registrant’s securities also acts as a principal underwriter, depositor, sponsor, or investment adviser.
(b) Management. Provide the information required by the following table with respect to each director, officer, or partner of each principal underwriter named in the response to Item 23:
Instruction. If a principal underwriter is the Depositor or an affiliate of the Depositor, and is also an insurance company, the above information for officers or directors need only be provided for officers or directors who are engaged directly or indirectly in activities relating to the Registrant or the Contracts, and for executive officers including the Depositor’s or its affiliate’s president, secretary, treasurer, and vice presidents who have authority to act as president in his or her absence.
(c) Compensation From the Registrant. Provide the information required by the following table for all commissions and other
compensation received, directly or indirectly, from the Registrant during the Registrant’s last fiscal year by each principal underwriter:
(1) Name and Principal Business Address
(2) Positions and Offices
with Depositor
(1) Name and Principal Business Address
(2) Positions and Offices
with Underwriter
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(1) Name of Principal
Underwriter
(2) Net Underwriting
Discounts and Commissions
(3) Compensation on
Redemption
(4) Brokerage
Commissions
(5) Other
Compensation
Instructions:
1. Disclose the type of services rendered in consideration for the compensation listed in column (5). 2. Information need not be given about the service of mailing proxies or periodic reports of the Registrant.
3. Exclude information about bona fide contracts with the Registrant or its Depositor for outside legal or auditing services, or
bona fide contracts for personal employment entered into with the Registrant or its Depositor in the ordinary course of business.
4. Exclude information about any service for which total payments of less than $15,000 were made during each of the last three fiscal years.
5. Exclude information about payments made under any agreement whereby another person contracts with the Registrant or its Depositor to perform as custodian or administrative or servicing agent.
Item 33. Location of Accounts and Records
State the name and address of each person maintaining physical possession of each account, book, or other document, required to be maintained by Section 31(a) [15 U.S.C. 80a-30(a)] and the rules under that section. Instruction. The Registrant may omit this information to the extent it is provided in its most recent report on Form N-CEN [17 CFR 274.101].
Item 34. Management Services
Provide a summary of the substantive provisions of any management-related service contract not discussed in Part A or Part B, disclosing the parties to the contract and the total amount paid and by whom for the Registrant’s last three fiscal years.
Instructions:
1. The instructions to Item 21(b) of this Form shall also apply to this Item.
2. Exclude information about any service provided for payments totaling less than $15,000 during each of the Registrant’s
last three fiscal years.
Item 35. Fee Representation Provide a representation of the Depositor that the fees and charges deducted under the Contracts, in the aggregate, are reasonable in relation to the services rendered, the expenses expected to be incurred, and the risks assumed by the Depositor.
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SIGNATURES Pursuant to the requirements of the Securities Act of 1933 and the Investment Company Act of 1940, the Registrant (certifies that it meets all of the requirements for effectiveness of this registration statement under rule 485(b) under the Securities Act and) has duly caused this registration statement to be signed on its behalf by the undersigned, duly authorized, in the City of , and State of , on this day of , .
(Registrant)
By (Signature)
(Title)
(Depositor)
By
(Name of officer of Depositor)
(Title)
Instruction:
If the registration statement is being filed only under the Securities Act or under both the Securities Act and the Investment Company Act, it should be signed by both the Registrant and the Depositor. If the registration statement is being filed only under the Investment Company Act, it should be signed only by the Registrant. Pursuant to the requirements of the Securities Act of 1933, this registration statement has been signed by the following persons in the capacities and on the dates indicated.
Signature Title Date